Boosting Breastmilk Supply Through Nutrition

The World Health Organization (WHO), the American Academy of Pediatrics (AAP), and the Institute of Medicine (IOM) recommend that infants should be exclusively breastfed for 6 months, and breastfeeding should be continued in addition to complementary feeding for 1 and up to 2 years.1-3

The beneficial effects of breastfeeding for the infant and mother are well recognized, and the #breastisbest campaign has made its impact on moms across the nation.2,3 Research suggests benefits to a healthy term baby include reduced risk for numerous health conditions. These benefits extend to the mom as well.    

Breastfeeding challenges

New mothers, mothers who are going back to work, mothers whose babies are experiencing a growth spurt, and moms who are further in their nursing journey often have one thing in common: the desire to increase their milk supply. Sometimes this is because baby isn’t gaining weight well enough, other times mom wants to create a freezer stash of breastmilk, or maybe mom just feels like she can’t keep up with baby’s growth spurt demands.

What’s a mother to do?

There are many possible issues that can be explored, with the support of a trained healthcare professional, to rule out problems with mom and baby that could be getting in the way when trying to establish an adequate milk supply and a healthy breastfeeding relationship.

Before embarking on a routine of the mother consuming any of the below-mentioned herbs and strategies or baby using formula, mother and baby should meet with a board-certified lactation consultant (IBCLC). An IBCLC can weigh baby before and after eating to check for proper milk transfer; check mom and baby for proper latch, and baby for tongue or lip tie, which can affect how efficiently baby removes milk from the breast; and recommend other tools to improve the breastfeeding relationship.4

One potential option to discuss with your healthcare practitioner is the use of galactagogues. Galactagogues are synthetic or plant molecules used to induce, maintain, and increase milk production.5 Let’s explore some studied nutritional approaches to increase mama’s milk supply.

Well-studied nutrition

Adequate hydration

Breastfeeding entails producing large amounts of nutrient-dense fluid for baby’s nutrition. The average baby consumes 19-30 ounces (562-887 ml) of milk per day, but mother’s additional hydration needs exceed the amount of milk produced.6 According to the Dietary Reference Intakes set forth by the Institute of Medicine (IOM), mom needs around an extra 34 ounces (1000 ml) of water each day.7 This amount may increase in dry or hot conditions where mom is losing water through sweat or speaking, as well as if she’s exercising.

Adequate calories

Calorie needs for breastfeeding moms depend on how much energy mom is exerting daily, plus how much milk she is producing. On average, an exclusively breastfeeding mother needs about 500-640 calories more per day than she did before pregnancy.8-9

Palm dates and fenugreek

A study looking at three groups of 25 new moms observed the effects of fenugreek, palm dates, and no galactagogue (control group) on breast milk production. They found that consuming 10 palm dates (100 g) three times per day provided the largest increase in milk supply, but the group consuming fenugreek tea (2 tablespoons per cup of tea, 3 cups of tea per day) also saw improved milk output during the early postpartum period.10

Questionably beneficial

Oats & brewer’s yeast

There is no solid evidence that eating oatmeal or lactation cookies containing oatmeal and brewer’s yeast will help to increase a mother’s supply in the early days or later days of nursing. That said, oatmeal can still be an easy-to-prepare meal, helping mom to consume enough calories and some key vitamins and minerals, including iron, magnesium, and B vitamins.

Milk supply depressors

Peppermint, sage, parsley, and monk’s pepper are herbs found in some teas and women’s preparations. In routinely consumed amounts these herbs have shown to decrease milk supply; in culinary amounts found as seasoning in a meal, no such effect is expected.11,12

Other factors to consider

When it comes to babies in general, parents are often left with so many unanswered questions. If mom believes she is having low milk supply issues, she should be sure to eat enough calories, drink copious amounts of fluids (preferably water or water with electrolytes), get enough sleep (insert eye roll, we know, but really!), and manage stress. Ensuring mom and baby practice skin-to-skin contact and that breasts are emptied of milk at regular intervals (when baby nurses) will also help the mother’s body to increase supply for her baby’s demand.13

For more information on supplements to support increased milk production, stay tuned for part 2 of this series on nutrition to boost breast milk supply.

References:

1. Sim TF et al. The use, perceived effectiveness and safety of herbal galactagogues during breastfeeding: a qualitative study. Int J Environ Res Public Health. 2015;12:11050–11071.
2. Mathur NB et al. Breastfeeding. Indian J Pediatr. 2014;81:143–149.
3. Breastfeeding and the use of human milk. Pediatrics. 2012;129(3):e827-841.
4. Scope of Practice for International Board-Certified Lactation Consultant® (IBCLC®) Certificants. (2018). [ebook] Available at: https://iblce.org/wp-content/uploads/2018/12/scope-of-practice-2018.pdf [Accessed July 2, 2019].
5. Mortel M et al. Systematic review of the efficacy of herbal galactogogues. J Hum Lact. 2013;29(2):154-162.
6. Dewey KG et al. Milk and nutrient intake of breast-fed infants from 1 to 6 months: relation to growth and fatness. J Pediatr Gastroenterol Nutr. 1983;2(3):497-506.
7. “Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate” at NAP.edu. National Academies Press: OpenBook, 2005, www.nap.edu/read/10925/chapter/1.
8. Institute of Medicine (US) Committee on Nutritional Status During Pregnancy and Lactation. Nutrition During Lactation. Washington (DC): National Academies Press (US); 1991. 9, Meeting Maternal Nutrient Needs During Lactation. https://www.ncbi.nlm.nih.gov/books/NBK235579/
9. Kominiarek MA et al. Nutrition recommendations in pregnancy and lactation. Med Clin North Am. 2016;100(6):1199–1215.
10. Sakka AE et al. The effect of fenugreek herbal tea and palm dates on breast milk production and infant weight. Journal of Pediatric Sciences. 2014;6:e202.
11. Anderson PO. Herbal use during breastfeeding. Breastfeed Med. 2017;12(9):507-509. 
12. Romm Aet al. Breastfeeding and botanical medicine. In Humphrey S and Romm A, Botanical medicine for women’s health. St. Louis, Missouri: Churchill-Livingstone; 2010;(18)433-454.
13. Kent JC et al. Principles for maintaining or increasing breast milk production. J Obstet Gynecol Neonatal Nurs. 2012;41(1):114-121.

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